"The true inequity": Factors that make Māori and Pacific people more vulnerable to Covid-19

Opinion: Dr Maryann Heather and Dr Rhys Jones examine the factors that make Māori and Pacific communities within Aotearoa more at-risk amidst the Covid-19 pandemic.

“Pacific communities in New Zealand are facing various challenges" - Dr Maryann Heather

Pacific communities in New Zealand are facing various challenges in this pandemic. In particular, doctors are expressing serious concern that people have not been seeking medical care during lockdown, and are therefore experiencing far more urgent issues when their condition deteriorates. As we move towards Alert Level 2, there is likely to be a surge in the number of patients seeking care from their GPs, or requiring treatment at hospital, with acute medical concerns. We strongly urge people to seek advice and treatment for any health issues as soon as possible, particularly if a patient has a condition which requires frequent monitoring.

Alongside these issues, there has also been a hesitancy among some Pacific people to get tested for Covid-19. This is in part due to fear of having the virus, but also a fear of needing to take time off work, and of placing a financial strain on family as a result.

This has proven particularly problematic for families living with financial difficulties. The need to report any symptoms of Covid-19, and to be tested as quickly as possible, must continue to be communicated to these communities. In South Auckland, Pacific language-speaking staff have facilitated testing where language remains a barrier.

For many large family groups, physical distancing has been particularly challenging. Depression, anxiety and isolation are serious issues in these communities, but the importance of protecting our bubbles and maintaining physical boundaries must continue to be emphasised while we remain at Alert Level 3.

The prevalence of underlying health conditions such as cardiovascular, respiratory and kidney diseases, diabetes and cancer is much higher in Māori populations than in non-Māori. Māori also tend to get these diseases at younger ages and are more likely to have multiple conditions, which exacerbates the risks posed by Covid-19. This means that Māori are more likely to experience serious outcomes from Covid-19.

Researchers at Te Pūnaha Matatini have modelled how infection fatality rates for Covid-19 (the risk of dying for those who are infected) may vary by ethnicity. Their findings are alarming. The estimated infection fatality rate for Māori is between 1.5 and 2.5 times as high as the rate for non-Māori. In other words, on average, Māori people who become infected are approximately twice as likely to die as non-Māori people with Covid-19.

Those numbers almost certainly underestimate the true inequity. The infection fatality rate is probably even higher for Māori due to other factors not captured in the study’s analysis, such as racism in the health and disability system and other inequities.

And that’s without even considering the greater risk of being exposed to Covid-19 for Māori (and Pacific) communities due to crowded housing and higher intergenerational contact rates.

That’s why many are so concerned about the prospect of Covid-19 transmission becoming established in Māori communities. That’s why whānau, hapū, iwi and Māori communities are taking specific actions in an attempt to keep the virus out. As we move towards Alert Level 2, it is critical that control measures take into account the disproportionate threat of Covid-19 for Māori communities, and in particular for groups in our communities who experience multiple oppressions such as disabled people, those with chronic health conditions, and sexual and gender minorities.